Seldin D W, Heiken J P, Feldman F, Alderson P O
J Nucl Med. 1985 Sep;26(9):988-93.
Three-phase bone scans were performed on 30 diabetic patients suspected of having acute pedal osteomyelitis; 23 also had a pedal ulcer, seven had coexisting cellulitis, and 14 had diminished pedal pulses. Fifteen patients were receiving antibiotics at the time of the scan. A tissue diagnosis was available in 18 patients and 12 had no clinical evidence of infection on follow-up. Focal arterial hyperemia combined with focally increased activity on blood-pool and delayed (2-3 hr) scans were interpreted as acute osteomyelitis. Scans showing venous hyperemia were interpreted as soft-tissue pathology without acute osteomyelitis. Companion radiographs were reviewed independently. The sensitivity and specificity of the scans for osteomyelitis were 0.94 and 0.79, respectively, while radiographic sensitivity was 0.93 and specificity was 0.50. The presence of soft-tissue ulcers or cellulitis, peripheral vascular disease, or recent antibiotic therapy had no significant adverse effect on the accuracy of the three-phase scan in diagnosing osteomyelitis.
对30名疑似患有急性足部骨髓炎的糖尿病患者进行了三相骨扫描；其中23人同时患有足部溃疡，7人并发蜂窝织炎，14人足部脉搏减弱。15名患者在扫描时正在接受抗生素治疗。18名患者获得了组织诊断，12名患者在随访中没有感染的临床证据。局灶性动脉充血，结合血池期和延迟（2 - 3小时）扫描时局灶性活性增加，被解释为急性骨髓炎。显示静脉充血的扫描被解释为无急性骨髓炎的软组织病变。对配套的X线片进行了独立评估。扫描对骨髓炎的敏感性和特异性分别为0.94和0.79，而X线片的敏感性为0.93，特异性为0.50。软组织溃疡或蜂窝织炎、周围血管疾病或近期抗生素治疗的存在，对三相扫描诊断骨髓炎的准确性没有显著的不利影响。
